Infection in utero with T. pallidum causes an illness of varying severity in children. Those under 2 years of age may present with hepatosplenomegaly, rash, condyloma lata, snuffles, jaundice (nonviral hepatitis), pseudoparalysis, anemia, or edema from nephrotic syndrome and/or malnutrition. Older children may have the stigmata of syphilis: interstitial keratitis, nerve deafness, anterior bowing of the shins, frontal bossing, mulberry molars, Hutchinson teeth, saddle nose, rhagades, or Clutton joints.
Identification of T. pallidum by dark-field microscopy, fluorescent antibody, or other specific stains in specimens from lesions, placenta, cord blood, or autopsy material confirms the diagnosis.
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